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Choking

Choking is an emergency. Call 911 emergency medical services. Do not attempt to drive a choking person to a hospital emergency department.

What to do if a person starts to choke:

* It is best not to do anything if the person is coughing forcefully and not turning a bluish color. Ask, "Are you choking?" If the person is able to answer you by speaking, it is a partial airway obstruction. Stay with the person and encourage him or her to cough until the obstruction is cleared.* Do not give the person anything to drink because fluids may take up space needed for the passage of air.

Someone who cannot answer by speaking and can only nod the head has a complete airway obstruction and needs emergency help.

The treatment for a choking person who begins to turn blue or stops breathing varies with the person's age. In adults and children older than one year of age, abdominal thrusts (formerly referred to as the "Heimlich maneuver") should be attempted. This is a thrust that creates an artificial cough. It may be forceful enough to clear the airway.

The quick, upward abdominal thrusts force the diaphragm upward very suddenly, making the chest cavity smaller. This has the effect of rapidly compressing the lungs and forcing air out. The rush of air out will hopefully force out whatever is causing the person to choke.

How to perform abdominal thrusts

* Lean the person forward slightly and stand behind him or her. Make a fist with one hand. Put your arms around the person and grasp your fist with your other hand in the midline just below the ribs. Make a quick, hard movement inward and upward in an attempt to assist the person in coughing up the object. This maneuver should be repeated until the person is able to breathe or loses consciousness.

*If the person loses consciousness gently lay him or her flat on their back on the floor. To clear the airway, kneel next to the person and put the heel of your hand against the middle of the abdomen, just below the ribs. Place your other hand on top and press inward and upward five times with both hands. If the airway clears and the person is still unresponsive, begin CPR.* For babies (younger than one year of age), the child will be too small for abdominal thrusts to be successful. Instead, the infant should be picked up and five back blows should be administered, followed by five chest thrusts. Be careful to hold the infant with the head angled down to let gravity assist with clearing the airway. Also be careful to support the infant's head. If the infant turns blue or becomes unresponsive, CPR should be done.* If you are in doubt about what to do, and you are witnessing someone choking, call for emergency help immediately, do not delay. You may be able to successfully stop the choking before help arrives using techniques discussed here, but it is best for the choking person to be evaluated by the emergency medical team when they arrive. If something is still in the person's throat, the emergency medical team can begin care immediately and take the person to the hospital for further treatment.